Patient Navigation for the Care Needs of Cancer Survivors: A Scoping Review

Abstract

Background:

Cancer care increasingly emphasizes holistic, patient-centered support across the disease trajectory; however, many health systems lack sufficient resources to address patients’ physical, psychosocial, and logistical care needs, particularly in under-resourced settings. Patient navigation, delivered by trained non-clinician, peer, or community-based navigators, has demonstrated effectiveness in improving cancer screening and treatment initiation, yet its role in addressing the ongoing health and related care needs of people living with cancer remains less well characterized.

Methods:

This scoping review aimed to synthesize peer-reviewed and gray literature evaluating patient navigation interventions focused on the care needs of people living with cancer to summarize program characteristics, facilitators, and barriers. A search of Ovid MEDLINE (1990—June 2024) identified 4300 records.

Results:

Following rigorous screening and data extraction, 17 studies met the inclusion criteria. Most studies were conducted in the United States (88%), and over half employed randomized or cohort designs. Navigation programs varied widely in patient populations, cancer types, intervention duration, delivery modality, and navigator training and roles. Nearly half of the studies targeted under-resourced or marginalized populations. Interventions commonly addressed unmet needs, symptom management, care coordination, survivorship, palliative and end-of-life care, insurance, or psychosocial support. Across heterogeneous outcomes, most studies reported statistically significant improvements in patient-reported outcomes (e.g., quality of life, self-efficacy, psychosocial well-being), navigation process outcomes (e.g., satisfaction, feasibility, navigator–patient relationships), and, less frequently, health-related outcomes such as health care access and utilization. Key facilitators included strong institutional infrastructure, integration within oncology teams, flexible and accessible delivery, cultural responsiveness, and robust navigator training and supervision. Barriers included limited perceived need among lower-acuity patients, role ambiguity, technological challenges, insufficient follow-up, reimbursement constraints, and mismatches between program intensity and patient or caregiver needs.

Conclusions:

Findings highlight the importance of flexible, relationship-centered, and well-integrated patient navigation models and underscore the need for standardized training, sustainable reimbursement, and patient-driven programs designed to optimize impact and equity.